A hidden aspect of the U.S. opioid crisis: Rise in first-time treatment admissions for older adults with opioid use disorder

• Published in: Drug and alcohol dependence Vol. 193; pp. 142 - 147
• Main Authors: Huhn, Andrew S., Strain, Eric C., Tompkins, D. Andrew, Dunn, Kelly E.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-12-2018; Elsevier Science Ltd
• Subjects: Addictions; Adults; African Americans; Complex patients; Demographics; Demography; Drug abuse; Drug addiction; Elder care; Help seeking behavior; Heroin; Narcotics; Nasal sprays; Older adults; Older people; Opioid use disorder; Opioids; Patient admissions; Population studies; Prescription drugs; Prescription opioids; Regression analysis; Substance abuse treatment; Substance use disorder; Treatment; Trend analysis; Trends; United States > US; AOR; CI; Opioid use disorder; IV; AAPC; Older adults; Treatment; TEDS-A; OMT; Trend analysis; Prescription opioids; Heroin; OUD; DSM
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2018.10.002

•There was a recent surge in older adults seeking treatment for opioid use disorder.•Older adults seeking treatment for heroin use increased 110% between 2012–2015.•This population is increasingly female and African American.•Older adults are increasingly seeking treatment outside of urban areas.
Older adults with opioid use disorder (OUD) are a medically complex population. The current study evaluated trends in older adults seeking treatment for OUD, with a focus on primary heroin versus prescription opioid use. This study also compared older adults with OUD to the younger OUD population on demographics and drug use behaviors.
Publicly available data from state-certified addiction treatment centers were collected via the Treatment Episode Data Set – Admissions (TEDS-A) between 2004–2015. This study utilized Joinpoint Regression to conduct a cross-sectional, longitudinal analysis of trends in first-time treatment admissions for OUD in adults 55 and older (older adults; n = 400,421) versus adults under the age of 55 (n = 7,795,839). Given the rapid increase in older adults seeking treatment for OUD between 2013–2015, secondary outcomes include changes in demographics and drug use between 2012 (as a baseline year) and 2015.
The proportion of older adults seeking treatment for OUD rose steadily between 2004–2013 (41.2% increase; p-trend = 0.046), then rapidly between 2013–2015 (53.5% increase; p-trend = 0.009). The proportion of older adults with primary heroin use more than doubled between 2012–2015 (p < 0.001); these individuals were increasingly male (p < 0.001), African American (p < 0.001), and using via the intranasal route of administration (p < 0.001).
There has been a recent surge in older adults seeking treatment for OUD, particularly those with primary heroin use. Specialized treatment options for this population are critically needed, and capacity for tailored elder care OUD treatments will need to increase if these trends continue.